Namibia failing to end forced sterilisation

On 4 November the African Commission on Human and Peoples’ Rights passed a resolution condemning the practice of coerced sterilisation of marginalised women, including women living with HIV. The resolution reaffirmed that sterilisation can only be done with the full, free and informed consent of the woman. It further called on countries in Africa to put in “place mechanisms to ensure that women living with HIV are not subjected to coercion, pressure or undue inducement by healthcare providers and/or institutions in order to secure consent for sterilisations”, among others.

This resolution by the African Commission is a significant step forward in making it clear that coerced sterilisation occurs throughout Africa, that it violates fundamental rights, and that African countries must take meaningful steps to end the practice, including training medical personnel and providing reparations to women who have been subjected to coerced sterilisation.

In Namibia, dozens of women living with HIV have been subjected to forced or coerced sterilisation at public hospitals throughout the country.

I have spent over 5 years listening to their grief at not being able to have children again, and in some cases, their fear of continued abuse by their husbands, families, and communities due to their inability to bear children. With others, I have called on the Namibian government, at a bare minimum, to place circulars in public hospitals outlining what information a woman needs to be given and in what manner before she can consent to a sterilisation and provide regular training to medical personnel on informed consent.

However, in the past five years, since this practice has come to light, the Namibian government has done nothing to end this practice. In July 2012, the High Court ruled that three women living with HIV had been subjected to coerced sterilisation in violation of the laws of Namibia and were thus, entitled to compensation. Even after this decision by the High Court, the government has chosen not to address the issue and indeed, has chosen to appeal the High Court decision thereby delaying the justice that all these women deserve.

Informed consent is what is at the heart of this issue. According to the law and general practice, all of us need to give our informed consent before a doctor or nurse can perform a medical procedure, including sterilisation, on us. Informed consent means getting all of the information about the procedure, including how it will be done and any side effects; getting that information in a language that the patient understands; and giving the patient adequate time to consider the information and make an informed decision.

The African Commission resolution reaffirms that the obligation of obtaining informed consent exists not only under Namibian law but also under regional law which applies to Namibia having signed the African Charter on Human and Peoples’ Rights and the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa.

The resolution also makes clear that these legal requirements should not be used as a way to deny women access to desired health services, including sterilisation. I have spoken to a number of women who are denied access to health services because medical personnel claim that they fear retribution in light of the legal case on coerced sterilisation. As long as medical personnel are trained on the law and abide by it they should have no cause for concern.

The time has come for the Namibian government to ensure the end of the practice of coerced sterilisation by issuing circulars in all public hospitals throughout Namibia, training medical personnel on informed consent, including on how to ensure access to all services, investigating claims of coerced sterilisations and paying reparations where appropriate.